Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 4483 | NV |
NPI | 1376606608 |
---|---|
Provider Name | Dr. David Lawrence Brizzee |
First Address | Spring Creek, NV 89815-7424 |
Second Address | Elko, NV 89801-5072 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2006 |
Last Update Date | 08/07/2007 |